Benner’s theory of Novice to Expert has been adopted by the operating room where I practice. This theory was chosen because the operating room has unique educational requirements and novice versus expert hierarchy issues that are not usually found in general nursing units. The intent of this paper is to give a brief history of the evolution of nursing and how the practice of nursing has evolved into a theory based profession. The next section, Benner’s theory, Novice to Expert, will contain an analysis of the key concepts of the theory and how this theory relates to the nursing metaparadigm. The third section will illustrate how Benner’s theory is applied in clinical practice and outline the roles of nurses, nursing leadership and nurse educators. Lastly, the fourth section will conclude what has been learned from analyzing this theory. The Importance of Nursing Theory

The nursing profession has been around for centuries, long before formal education was introduced. In 1863 the University of Pennsylvania offered a six month course in nursing, and is considered one of the first organized schools for nurse in the United States. Many other schools followed suit, and began offering formal education for nurses under the direction of physicians, and was structured as an on-the-job training program within the hospitals. These colleges taught the same theoretical format to the nursing students, using mainly rules, principles of practice and traditions. In the same era, Florence Nightingale was creating an education and theoretical approach to nursing in Europe. As the profession established itself as a care-maiden to physicians, the profession and the theory of nursing practice didn’t advance until nearly a century later.

Beginning in the early 1950s, nursing practice took a dramatic change from rules and tradition to scientifically based higher education and practice theory. In the 70s, the National League of Nursing required that nursing curricula be based on theoretical and conceptual framework. At this time theorists began to advance and expand as colleges taught nursing theory as a framework for higher education. Nursing theory defines the nature, structure, concepts and relationships between nursing concepts (Fawcett 1995, Meleis 2005). Patricia Benner is a nursing theorist who first published From Novice to Expert: Excellence and Power in Clinical Nursing Practice, in 1984. This theory is still widely used and respected, and has continued to evolve. According to Benner, the theory of nursing encompasses both the medical and nursing scientific knowledge that has been imparted to the trainee, mostly in nursing school, and the rules of thumb that are largely acquired during on-the-job training and experience (Benner, Tanner & Chesla, 2009). This theory outlines the evolution of the nurse from novice to expert in professional practice and focuses on the nurse’s role independent of the physician. Benner’s Theory, Novice to Expert

Benner‘s theory, Novice to Expert, states that practice and theory are intertwined. Neither can stand alone, and each play an integral role in the development and proficiency of the practicing nurse. To further describe the importance of the relationship between theory and practice and define the purpose of the theory, Benner states, “nursing is a caring practice that goes beyond theory altogether and shows that where human meaning is at stake, one needs a kind of intuition that can never be captured by rational theory, theory is dependent on practice, and reason requires intuition”(Benner, Tanner & Chesla, 2009). This has been my experience as a new nurse in the operating room many years ago and, presently, as an operating room nursing director. Benner’s theory is designed around several phases in the evolution of the nurse from entering the field after graduation, to achieving a level of practice competence, to becoming an expert with the ability to...

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